Going for Tulsa Pro

Posted by paulcalif @paulcalif, Dec 29, 2024

I've posted here a few times over the last year and have read most of the posts from others. I was diagnosed in January 2024 through an ultrasound biopsy (it should have been MRI guided), followed by a PSA test CT scan, MRI, and Decipher test. My cancer is not aggressive, but there are three growths in my prostate. My doctors recommended a full ablation, and I’ve decided to go with the Tulsa Procedure at UCLA with Dr. Steven Raman.

I’ve waited until now because I believe Medicare will begin covering the procedure on the 1st. of 2025. Earlier this year, I switched from a Medicare HMO plan (Blue Shield) to Original Medicare with a supplemental plan, where Medicare covers 80% and the supplemental plan pays the remaining 20%. It’s been incredibly difficult to determine whether Medicare will actually cover the procedure, as I’ve received conflicting information. However, I think they will.

I considered going back to an HMO with United Health Plans, which includes UCLA physicians as in-network, but no one could guarantee that they’d cover the procedure either.

Anyway, I thought I’d document this journey. It begins on January 5th, when I’ll check into an Airbnb hotel near the procedure location. This is two days before the procedure. I’ll have to fast those 2 days and completely empty my stomach (I’ll spare you the details). In the best-case scenario, I’ll wake up with a catheter and a “burned out” prostate. I’ll need to wear the catheter for at least two weeks. Hopefully, they'll get it all 🙂

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Profile picture for bjroc @bjroc

When it is near the rectum, HIFU is an alternative option that uses the same technology as Tulsa, so that person can look up HIFU providers plus Tulsa providers. Only trouble is if they have significant BPH they won't use HIFU. But HIFU would be the additional option when lesion is near rectum.

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Agree, if the tumor is on the rear of the prostate, or the prostate is small, then HIFU is best. HIFU goes through your rectum. If you have a normal or enlarged prostate and your tumor is on the front of the prostate then TULSA PRO is best since the probe goes through your urethrae

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Profile picture for clandeboye1 @clandeboye1

I am considering NanoKnife , TULSA PRO or Mono SBRT ( 5 TREATMENTS )

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You should ask for a Prostox test by MiraDx. This test tells you if you will have any Grade 2 or higher GU long term issues after SBRT treatment. Some Drs don't know what this test is, but Mayo Jax gave me the order when we were consider SBRT. Mine came back that I was at a 95% change of having long term GU issues at or above Grade 2. I also looked at IRE (NanoKnife) but was told I am not a good candidate because my tumor measurers 2.2 cm, too large. So I am going to do TULSA PRo instead. My tumor is in the transition zone so it makes me a great candidate for TULSA Pro. They said I was a textbook patient for it. Let's pray it works long term for me.

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Profile picture for clandeboye1 @clandeboye1

Paul,
Thanks for the response . My PSA is 8.4 really 16.8 considering the doubling effect of Dutasteride which I have been taking for 4 1/2 years for my BPH . Otherwise at very close to 85 I am pretty healthy and fit, excluding of course my Gleason 6 prostate cancer .

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85 and you only have 3+3=6? How many cores of the biopsy? If strait up Adenocarcinoma and no other variants you should consider Active Sur valence. Up to your Drs of course, and I am not one, but why mess with 3+3=6. That is really considered pre-cancerous by Oncologists.

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Received my PSA result a few days ago, it is a 0.10 ng/mL. I had TULSA on 28 Feb, 2025 and this is the 3 month full gland ablation post treatment PSA. At the two month mark I began to lose my sex drive and have some mild ED, that I think is likely from low Testosterone. I see my local Uro tomorrow to discuss the PSA and low T. All in all, very pleased with TULSA, no regrets.

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As a Vietnam veteran my prostate cancer claim is covered under the VA because of Agent Orange exposure. But TULSA isn't covered. The Dr. at my VA clinic never heard of TULSA. I did my own research and asked them to refer me to OU which they did. I had to pay for the procedure out of pocked but the VA covers the Dr. visits and other treatment. I go back June 3rd for a follow up MRI. VAs involvement depends on your disability status. If you haven't already applied, you should file a claim for your cancer.

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Profile picture for bobbygene @bobbygene

I had TULSA in November and returned for follow up March 4. I had labs done at the VA two weeks ago and PSA was 0.88. OU checked my PSA on Mar. 4 and it was 0.7. Before the procedure it was around 10. Dr. Stratton was very pleased and told me it couldn't get any better. My only side effect is dry orgasm. Erection is about like it was before the procedure. Dr. wrote a prescription for Viagra. I go back in June for an MRI. I'm very happy with my decision to go with TULSA PRO.

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BobbieGene
I am hoping to use the TULSA treatment, if I qualify. And I am also a veteran with full VA benefits. I am not looking for the VA to fund the treatment. I could not find any information within the VA Libraries or even doctors who were familiar with TULSA or a POC .... so with the lack of transparency and red tape at the VA to discuss the issue of TULSA treatment. I am going to decide the "when and where" and my insurances will cover the cost. However I don't know if VA needs to have input... Could you provide me any type of POC or even a reference of the VA's opinion?
BGJCL

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Profile picture for markc68 @markc68

Problem is that mri was in 2024. Dr never gave that a second thought until 2025. 1 year later when my psa bumped. Then we started antibiotics and repeated mri 1 yr from 1st mri. 1st mri said possible prostatitis in 2024. MRI in 2025 after antibiotics read out the pi-rad5’s. Also looks like my prostrate has grown a lot in 1 year🤷🏻‍♂️

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Dutasteride and sweet wormwood.

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Profile picture for bjroc @bjroc

I see that word in your 2024 MRI "prostatitis". It can cause almost everything you have from PSA to elevated pirads. I suspect the prostatitis is the main issue, because it messes with imaging and causes all kinds of error like throwing the pirads rating into a tizzy. Doesn't mean there isn't something there, but it is likely the issue causing imaging to be all over. Doc following right path, follow psa, another biopsy later. That being said for prostatitis sometimes antibiotics help, most times not, sometimes an OTC like liquid drops of sweet wormwood (not plain wormwood) or artemisia annua but just add liquid drops to drink for a month or two, over time it helps about as much as antibiotics which is just sometimes.

AI search "artemisia annua sweet wormwood antibiotic effect"
Artemisia annua, also known as sweet wormwood, has demonstrated significant antibacterial activity, particularly against a range of bacteria and parasites.

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Problem is that mri was in 2024. Dr never gave that a second thought until 2025. 1 year later when my psa bumped. Then we started antibiotics and repeated mri 1 yr from 1st mri. 1st mri said possible prostatitis in 2024. MRI in 2025 after antibiotics read out the pi-rad5’s. Also looks like my prostrate has grown a lot in 1 year🤷🏻‍♂️

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Profile picture for markc68 @markc68

Have follow up on Tuesday. Dr only wanted to repeat psa in 6 months but we insisted on a sit down. In mean time we are working on second opinion. Psa has gradually gone up but has been sitting around 5.5 for last couple years. This spring it jumped to 7.8 and they put me on doxycycline for 6 weeks and repeated psa after it was complete. Psa came back down to around 5 but he wanted to do mri. After results of mri urologist wanted to do bx. Was not mri guided but was ultrasound guided. Just scared he missed the areas of interest. I had mri little over 1 yr ago and they seen nothing of interest. I attached mri from Feb of last year. Before mri I ask urologist about psma scan and he was like, let’s just see what bx shows first. If positive we will do one. In process of getting all medical records around for second opinion. I have read that some pi-rad5’s can be benign but very rare? Thanks everyone.

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If it wasn’t MRI guided why even bother? He had you get an MRI and then did NOT use it to do the biopsy?? Am I missing something here?
Not to beat a dead horse but you should have a transperineal biopsy which can access all areas of the gland. Who knows if your Uro even hit these areas?
Also, your MRI went from PIRADS2 to PIRADS5….and that’s a six month wait and see? Please get away from this person no matter how much you like him.
Phil

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Profile picture for markc68 @markc68

Have follow up on Tuesday. Dr only wanted to repeat psa in 6 months but we insisted on a sit down. In mean time we are working on second opinion. Psa has gradually gone up but has been sitting around 5.5 for last couple years. This spring it jumped to 7.8 and they put me on doxycycline for 6 weeks and repeated psa after it was complete. Psa came back down to around 5 but he wanted to do mri. After results of mri urologist wanted to do bx. Was not mri guided but was ultrasound guided. Just scared he missed the areas of interest. I had mri little over 1 yr ago and they seen nothing of interest. I attached mri from Feb of last year. Before mri I ask urologist about psma scan and he was like, let’s just see what bx shows first. If positive we will do one. In process of getting all medical records around for second opinion. I have read that some pi-rad5’s can be benign but very rare? Thanks everyone.

Jump to this post

I see that word in your 2024 MRI "prostatitis". It can cause almost everything you have from PSA to elevated pirads. I suspect the prostatitis is the main issue, because it messes with imaging and causes all kinds of error like throwing the pirads rating into a tizzy. Doesn't mean there isn't something there, but it is likely the issue causing imaging to be all over. Doc following right path, follow psa, another biopsy later. That being said for prostatitis sometimes antibiotics help, most times not, sometimes an OTC like liquid drops of sweet wormwood (not plain wormwood) or artemisia annua but just add liquid drops to drink for a month or two, over time it helps about as much as antibiotics which is just sometimes.

AI search "artemisia annua sweet wormwood antibiotic effect"
Artemisia annua, also known as sweet wormwood, has demonstrated significant antibacterial activity, particularly against a range of bacteria and parasites.

REPLY
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